VSZ-HS-HSC-006

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Project:

  UFB

  M&P

  Build Services

• Work Activity:

• Does the work involve working with Electricity?

  Yes

  No

  N/A

• Above the line controls observed/comments:

• Can the work result in in a fall of more than 2 meters

  Yes

  No

  N/A

• Above the line controls observed/comments:

• Does the work require persons to drive longer than 2 hours

  Yes

  No

  N/A

• Above the line controls observed/comments:

• Are workers required to work in the vicinity of overhead/underground utilities?

  Yes

  No

  N/A

• Above the line controls observed/comments:

• Does the work require persons to excavate deeper than 1.5 mteres?

  Yes

  No

  N/A

• Above the line controls observed/comments:

• Is the worksite located in the vicinity of vehicular traffic?

  Yes

  No

  N/A

• Above the line controls observed/comments:

• Are workers required to work in or around mobile plant?

  Yes

  No

  N/A

• Above the line controls observed/comments:

• Are workers required to work in remote or isolated locations?

  Yes

  No

  N/A

• Above the line controls observed/comments:

• Does work involve heavy lifting (>75% of SWL)

  Yes

  No

  N/A

• Above the line controls observed/comments:

• Are workers exposed to asbestos?

  Yes

  No

  N/A

• Above the line controls observed/comments:

Environmental Impacts

• Is noise/air pollution a consideration?

  Yes

  No

  N/A

• Is fire management a consideration?

  Yes

  No

  N/A

• Is vehical wash down a consideration?

  Yes

  No

  N/A

• Is cultural heritage a consideration?

  Yes

  No

  N/A

• Is waste management a consideration?

  Yes

  No

  N/A

• Is water pollution/sediment control a consideration?

  Yes

  No

  N/A

• Is vegitation clearance/reintatement a consideration?

  Yes

  No

  N/A

• Is access a consideration?

  Yes

  No

  N/A

• Is prescribed waste disposal a consideration?

  Yes

  No

  N/A

• Is spill management a consideration?

  Yes

  No

  N/A

• Is flora/fauna a consideration?

  Yes

  No

  N/A

• Is noxious weeds/insects a consideration?

  Yes

  No

  N/A

General

• Is a relevant SWMS/JSA current and available?

  Yes

  No

  N/A

• Were staff wearing PPE as identified in the hazard control plan?

  Yes

  No

  N/A

• Were any significant safety breaches observed?

  Yes

  No

  N/A

• What was the latest Telco Safety Essentials information received by the workforce?

  Yes

  No

  N/A

• Topics Discussed:

• Comments/corrective actions required:

• Person Completing Visit

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